NPI was enforced as a part of the Health Insurance Portability and Accountability Act (HIPAA), adopted in 1996. Deadline for NPI usage by all the providers is May 23, 2007.

All individual HIPAA covered healthcare providers or organizations (hospitals, home health care agencies, nursing homes, residential treatment centers, group practices, laboratories, pharmacies, medical equipment companies, etc.) must obtain an NPI for use in all HIPAA standard transactions, even if a billing agency prepares the transaction. Once assigned, a provider's NPI is permanent and remains with the provider regardless or job or location changes.

Problem of storage and exchange

While submitting the claim to payer, provider should specify not only his NPI but also NPI of all referring providers mentioned in the claim. This becomes a huge mess for organizations that host these providers since they receive thousands of phone calls, faxes, e-mails, asking for NPI of their providers. The same problem exists for people who has thousands of referring providers and who need to call all the people.

The network of requests coming nowadays across the healthcare organization looks like below:

From diagram above it is clear that Center Point, which is some abstract person or department within Healthcare Organization, gets extremely overloaded, since the same or similar information should be distributed among the large amount of requestors. The major issue here is that information is practically the same � this is either full or limited list of NPI numbers, but lack of some secured and convenient sharing mechanism, Center Point should spend lots of time and money on such a routine operations that has nothing with the primary mission of the organization.

The same problem exists for Providers who should obtain big number of NPIs from other providers or organization, like shown below:

This is basically the same problem, but approached from another end. In this case Provider becomes overloaded and he is having hard time exchanging his NPI with others and retrieving external NPIs from his referrers.

Two essential parts of the desired solution

It is possible to outline that solution to the problem described above should be complex, since it doesn’t make much sense to solve one part of the problem leaving another unresolved.

Two main aspects are:

Easy and convenient sharing mechanism, incorporated into the NPI number database solution

NPI Sharing System

Some essential requirements to the NPI sharing system are:

Organization should have its own profile within the system, this profile should be secured with the password

Organization should have an ability to enter data once and then just share the information to anyone based on some predefined criteria like � “I want to share these and these provider’s NPI’s with this Outside provider or organization” or “I don’t care � please share all the list � I just want to give out a link or publish a link to the system on my website and don’t receive any calls or inquiries any longer”, …

Solution should be database driven in order to ensure that information is easily accessible and securely stored on the back-end

This should be an online solution so anyone can know where he needs to go first instead of bugging the Healthcare Organization. In some scenario the same database solution can be hosted within the Healthcare Organization to provide own control over the database.

NPI Lookup Database

In the situation when CMS doesn�t provide Dissimilation of the NPI Numbers it is obvious that solution should include also Lookup Database, populated with the NPI Numbers and corresponding Providers. Such kind of Database will eliminate all the short-coming requests which make 90% of the entire headache for some medical practices.

Diagram below shows how the NPI lookup Database can solve the problem of short request interactions:

National Provider Identification (NPI) Number Database solution

In order to satisfy the nowadays needs of the Healthcare community, there was created the NPI Number Database solution that incorporates all the intermediate solutions and best practices made before current time and solves all the NPI sharing problems people had to face with recently.

NPI Number Database contains the following components and has next benefits:

User profiles are completely independent, so you can manage your lists being sure they are secured properly

Ability to mail your lists as by e-mail as by regular snail mail to your partners or referrals

One time data entry with as many times of sharing as you need � you just give out the URL and forget about any problems or if you want URL can be published on the website and you can give out the access to anyone who is interested

Solution is online, so no matter where you are you can easily manage you NPI Number Database

Schematically, problems described before now can be easily solved the following way with use of NPI Number Database:

So all the parties become totally untied and no need to receive and send phone calls � there is one central point that keeps and shares the data in very easy and convenient manner.

On the first diagram above, Healthcare organizations performs single submission of all the NPI numbers it holds and then defines a rules of data access by Outside providers and at the same time receives the access information from them and shares this information one time with its Providers. After one-time activity is done no further interactions required � system starts working as bullet. If you need to populate more information � you can log into your profile and add or modify whatever you need.

In second case after all the parties have submitted their information, for Provider that has thousands of referring providers from organizations or standalone practices � there is no need to start the data collecting campaign � everything is already collected and ready to use � just submit you request and all the data is sent to you. Should you want to make a fast and easy NPI lookup, pre-populated database is at your service.

Benefits and ballpark savings estimates

Using NPI Number Database as a public solution you obtain the following direct benefits:

No need to keep the staff on responding on the calls, faxes, e-mails

All data is organized and accessible in easy and convenient manner

Information is secured

NPI Database is easily accessible online no matter what part of the world you�re at

Sharing becomes as easy as it never been since the time NPI was enforced back in 1996, rule Get it Use it Share it starts really working

Solution is absolutely free of charge

Table below shows the approximate estimate breakdown of the total savings for the average-size Healthcare organization:

Communication expenses (phone, fax, e-mails, disturbance in the work environment)

$3,000

$0**

Looses due to insecure data

$1,000

$0***

Total:

$78,000

$500

* - cost of maintenance and initial population
** - service is free of charge
*** - data is secured following industry leading standards of encryption

As it comes from that table above usage of NPI Number Database on the regular basis allows average-size Healthcare organization to cut the expenses by $77,500, which may be a grate benefit to the business.